Physician duties · PharmD · North Carolina
Signing for a Pharmacist in North Carolina: what the physician takes on
The agreement is mandatory for the clinician, which makes its duties mandatory for you. North Carolina calls the instrument a Written Collaborative Practice Agreement.
Represents NC's expanded 'Clinical Pharmacist Practitioner' (CPP) tier, not ordinary pharmacist licensure — base dispensing and statutory limited authority need no physician agreement and are out of scope here. CPP scope is permanently CPA-based, with no independence pathway. Qualification: BPS board certification, an ASHP-accredited residency plus 2 years' experience, or an approved certificate program. S.L. 2025-37 (eff. Oct. 1, 2025) removed the prior numeric cap on CPPs per physician — now 'any number' deemed supervisable — and reduced CPA review.
What you take on as the physician
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
Not codified — left to the agreement
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
first 6 months of the collaborative practice agreement: Monthly
21 NCAC 46 .3101(f)(6). Modality (in-person vs. telehealth) is not specified.
ongoing, after first 6 months: Every 6 months
If the supervising physician changes, the parties decide whether to restart the monthly-meeting period.
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Controlled-substance schedule limits are not specified in NC statute/rule for CPPs; a CPP with individual DEA registration may handle controlled substances per that registration — treat as uncertain/not schedule-restricted rather than assuming a specific limit.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — No pharmacist-ownership requirement — pharmacy permits (N.C. Gen. Stat. § 90-85.21; 21 NCAC 46 .1601) issue jointly to the owner (who may be a non-pharmacist/corporate entity) and a licensed pharmacist-manager, who must retain professional/operational control over dispensing.
Materially more permissive than the medical CPOM rules governing PA/NP/CRNA/CNM/CNS/RN above. Whether any additional ownership restriction applies specifically to Clinical Pharmacist Practitioner (CPP) practice was not separately confirmed in this research pass.
Legal sources for these rules (5)
- N.C. Gen. Stat. § 90-18.4 — Clinical Pharmacist Practitioners
- 21 N.C. Admin. Code 46 .3101 — Clinical Pharmacist Practitioner Approval
- NC Board of Pharmacy — Clinical Pharmacist Practitioner overviewsecondary
- NC Board of Pharmacy — Guidance on New CPP Authority (Aug. 25, 2025)secondary
- S.L. 2025-37 — CPP statutory reforms effective Oct. 1, 2025
What physicians charge for this role
Typical monthly compensation in North Carolina
$500 – $600
Estimate for one Pharmacist. Standard-tier state.
About North Carolina's rules
The NP 'SAVE Act' (full practice authority) has failed every session since 2021, most recently as S.B. 966 (2026) — NC NPs have no independent-practice pathway. PA 'team-based practice' (S.L. 2025-37/H.B. 67) is now LIVE: its June 30, 2026 trigger has passed, regardless of whether NCMB's conforming rules were finished by then. Several categories below (CRNA proximity/ratio/chart-review, CNM proximity) have no codified numeric standard — treat as open items to verify with the board, not an absence of one.
Other clinicians in North Carolina: see the state overview.